An implant that failed, removed and replaced

The situation

A lower right first molar implant, placed during a week-long trip abroad in 2023 along with several crowns. It was comfortable for a year. Then the gum around it became tender, then it started to feel different when she bit down, and by the time she rang us the crown had a detectable wobble.

She was apologetic on the phone, which we want to address directly: people who have treatment abroad are not foolish, and a failed implant is a clinical problem, not a moral one. We treat these cases regularly and without commentary.

What we found with this failed implant

The CBCT scan showed the implant had been placed into insufficient bone width, with the outer plate of bone lost around the upper two-thirds of the fixture. This is not a case of poor cleaning — the bone was never there to begin with. There was also cement left below the gum from when the crown was fitted, which had kept the tissue inflamed.

We were straightforward that the implant could not be saved. An implant that has lost that proportion of its support does not re-integrate.

What we did

The implant was removed, which is usually more straightforward than people fear — a failing implant is not firmly held. The socket was cleaned, the residual cement removed and the site grafted with a membrane to rebuild the missing outer wall.

Six months of healing before a second scan, which showed enough width to work with. A new, wider implant was placed in a slightly different position and left to integrate for a further three months. Crown fitted at nine months.

We also checked the other implants placed on the same trip. Two of the three were sound; the third we are monitoring at six-month intervals, and she knows exactly what we are watching for.

Timeline

• Month 0 — assessment and CBCT scan
• Month 1 — implant removed, site grafted
• Month 7 — second scan, new implant placed
• Month 10 — crown fitted
• Month 16 — review

What it cost

£4,100: £1,250 for the removal and graft, £2,450 for the replacement implant and crown, and £400 for the additional scan and reviews. Longer and dearer than doing it once properly, which is the honest summary of most of these cases.

The treatment is described on replacing failed implants, and our guide on dental implants abroad sets out what to check before booking.

“The hardest part was ringing up to ask for help with something I felt stupid about in the first place.”

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